Healthcare Provider Details

I. General information

NPI: 1710468533
Provider Name (Legal Business Name): REHS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 N MILWAUKEE AVE STE 7
CHICAGO IL
60622-9319
US

IV. Provider business mailing address

1286 N MILWAUKEE AVE STE 7
CHICAGO IL
60622-9319
US

V. Phone/Fax

Practice location:
  • Phone: 330-472-0506
  • Fax:
Mailing address:
  • Phone: 330-472-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number178.009793
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number178.009793
License Number StateIL

VIII. Authorized Official

Name: MR. ANDREW J REHS
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 330-472-0506